NO. I AIR AND TUBERCULOSIS HINSDALE lOI 



to two hundred cubic inches were introduced into the pleural cavity 

 on the affected side' 



The nitrogen gas introduced into the pleural cavity does not re- 

 main long without being absorbed, and in order to keep the lung 

 immobilized for six months or more, repeated injections are required. 

 When ordinary atmospheric air gains entrance to the pleural cavity 

 it constitutes the condition known as pneumothorax, and if the pneu- 

 mothorax becomes closed, the oxygen steadily diminishes and finally 

 disappears, the carbon dioxide decreases and the last element to 

 disappear is the nitrogen. This fact has been determined by chemical 

 analysis by Dory, Bouveret, LeConte, Ewald (Loomis) . The respira- 

 tions are always increased after the injections and the pulse rate is 

 lowered. A notable effect in Dr. Loomis' cases was the absolute con- 

 trol of pulmonary hemorrhage in cases where all other measurd^ 

 failed. 



Dr. Loomis' experience in eighteen cases treated by injections 

 of nitrogen gas was uniformly favorable, although not -curative. 

 Probably the fact that pulmonary hemorrhage is controlled is the 

 chief value of the method, though gain in weight followed the adop- 

 tion of this measure in all the cases. 



SONG CURE 



One method of pulmonary exercise lately advocated for tubercu- 

 lous patients is by singing.^ Singing invokes correct nasal breath- 

 ing and a maintenance of the elasticity and proper expansion of the 

 chest. The necessary breathing exercises promote an increased func- 

 tional activity of all parts of the lungs, including the apices where 

 tuberculosis usually first becomes evident. It is here that expansion 

 is most limited and the prevalent opinion is that this comparative 

 inactivity is a strong factor in the tendency of the disease. 



The " song cure " may be suitable in some cases of pulmonary 



' For a good description of the latest apparatus and a discussion of the 

 most approved methods see articles by Harry Lee Barnes and Frank Taylor 

 Fulton, and by Samuel Robinson and Cleaveland Floyd, Transactions of the 

 American Climatological Association, 1913, pp. 160-188, and. 1911, pp. 289-383. 

 A bibliography is given in Transactions, 1913, p. 170- 



See also Trans. American Sanatorium Association, 8th spring meeting, p. 

 16. Discussion by H. D. Chadwick, W. A. Griffin, E. S. Bullock, G. W. Hol- 

 den, J. J. Lloyd, Jr., L. Brown, J. Roddick Byers. 



See also Samuel Robinson, "Practical Treatment," edited by Musser and 

 Kelly, W. B. Saunders Co., Philadelphia, 1911, Vol. 3, p. 254- 



"Drs. Leslie and Horsford, The Hospital, London, Jan. 25, 1908. 



